A five step project management process is used here to guide health care facilities to begin or strengthen their work on rational use of antibiotics. The process can be applied anywhere however, interventions should always be adapted to local setting.
A variety of examples are provided to showcase the steps involved and different options to improve antibiotic use. Guidelines set by national-level authorities may exist and when possible should be consulted and incorporated into programs at the facility level. Read through all the steps for a comprehensive picture of the work that lies ahead: Engage, Assess, Plan, Implement and Evaluate. Ideally, the cycle should be continuously worked through, but the Toolbox can also be used to pick and choose individual materials that best fit your needs.
Selected Resources
| Resource | Description |
| Antimicrobial stewardship programmes in health-care facilities in low- and middle-income countries – a WHO practical toolkit | Guideline by WHO, provides a stepwise approach to plan, implement, and assess antimicrobial stewardship programs in low-resource settings at national and facility levels. Supported by an online training course (currently unavailable, WHO is updating their course website). |
| How to start an antimicrobial stewardship programme in a hospital | Review Article providing a guide for health care professionals to set up an antibiotic stewardship program. Provides step-by-step guidance through a 6 month process and links to relevant resources. Suitable for use worldwide. |
| Implementation resources for hospitals | Information portal with stewardship implementation resources from the US CDC, such as Urine Culture Stewardship in Hospitalized Patients and tools for tracking and reporting. See also Implementation Resources for Outpatient Facilities and Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals. |
| Antimicrobial Stewardship in Australian Hospitals | Book that assists healthcare facilities to develop and implement antimicrobial stewardship programs. Chapter 6 covers measure performances and evaluating tools, and Chapter 16 describes antimicrobial use in community and residential aged care. |
| A Concise Set of Structure and Process Indicators to Assess and Compare Antimicrobial Stewardship Programs Among EU and US Hospitals: Results From a Multinational Expert Panel | Suggested indicators to assess and compare antimicrobial stewardship programs in hospitals in different countries and health care systems. |
| Antimicrobial Stewardship Through Food Animal Agriculture Toolkit Module: Guidance for healthcare facilities and health professionals | Guidance for healthcare professionals and facilities that would like to consider food and meal services and procurement in their stewardship program. |
| Toolkit: Implementation of Best Practice Guidelines | Toolkit designed to assist health care facilities in maximizing the potential of clinical practice guidelines, through systematic and well-planned implementation. Developed by the Registered Nurses’ Association of Ontario (RNAO). |
| Model for Improvement, Institute for Healthcare Improvement | Framework used very successfully by hundreds of health care organizations in many countries, to improve many different health care processes and outcomes. The breakthrough series developed by IHI, demonstrates a structure for organizations to learn from each other and from experts in targeted areas. |